Project Summary/Abstract There is high interest in using the Internet to improve patient access to individual health information. With implementation of My HealtheVet (MHV), the personal health record "tethered" to the VA electronic record, there is increasing opportunity for patient-centered technology tools to improve self-care and patient-clinician communication. In-person authentication, required for full use of MHV functions, presumes patients have Internet access yet does not eliminate further needs related to the meaningful use of MHV. Factors such as low e-health literacy or computer competency may impede patient usage, limiting veterans'ability to benefit from MHV. Little is currently known about MHV users and their usage of the website. We propose an exploratory study to understand veteran use of MHV, and to examine barriers and drivers of MHV usage. Aim 1: To describe a cohort of veterans authenticated to use the MyHealtheVet website, delineating their experiences and satisfaction with its use. Aim 2: To identify key factors associated with MHV usage, exploring potential factors such as demographics, literacy levels, use of the Internet, health status, adherence, health activation levels, and preventive and self- management behaviors. Methods: A prospective cohort study will follow 310 MHV-authenticated veterans for six months. Leveraging the high volume of authentication at Portland VA Medical Center, patients will be recruited following the authentication process. Baseline surveys will examine patient demographics, health literacy, patient activation, Internet access, overall use of Internet, e-Health literacy. MHV Activity Reports will measure frequency of MHV use. Patient-level and contextual factors that are related to MHV usage will be explored. Patients'experiences with accessing and using the website will also be examined.